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Discussion Starter #1
Over the last year, my grandfather has had the following painful symptoms:

• Throbbing/Swollen calves & ankles
• If he keeps his legs straight, the pain goes away, but if he sits in a chair w/ his knees bent, the pain suddenly starts.

Any ideas what is going on? His local doctor just gave him pain medicine and sent him on his way.
 

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new doctor.
pain meds only mask the symptom, not cure the problem.


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this advice is worth what your paying for it.
 

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The pain when sitting sounds like sciatica, but I could be wrong. The swelling, probably need more info. In other words, does your grandfather have varicose veins, lymph issues, et al?

By chance, the pain medication the doctor gave your grandfather didn't happen to be Lyrica, did it? I had a neuro give that to me for pain arising out of a herniated disc in my neck and within a day I had cankles from hell and I had problems breathing. I didn't put two-and-two together immediately since I've had asthma and thought I just might be having an isolated incident; but after about a month of having problems breathing, I realized that the meds might be the cause. Sure enough, I researched it and not only is shortness of breath a side effect, but so was peripheral edema. I immediately tapered the drug off over the course of the next week.
 

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Edema can be caused by a LOT of things

Questions I'd ask are what is his current health status? Overweight? Diabetic? Medication?

Has he had blood work? Male Hormone Panel?


Foot, leg, and ankle swelling is common with the following situations:

Prolonged standing
Long airplane flights or automobile rides
Menstrual periods (for some women)
Pregnancy -- excessive swelling may be a sign of pre-eclampsia, a serious condition sometimes called toxemia, that includes high blood pressure and swelling
Being overweight
Increased age
Injury or trauma to your ankle or foot
Swollen legs may be a sign of heart failure, kidney failure, or liver failure. In these conditions, there is too much fluid in the body.

Other conditions that can cause swelling to one or both legs include:

Blood clot
Leg infection
Venous insufficiency (when the veins in your legs are unable to adequately pump blood back to the heart)
Varicose veins
Burns (including sunburn)
Insect bite or sting
Starvation or malnutrition
Surgery to your leg or foot
Certain medications may also cause your legs to swell:

Hormones like estrogen (in birth control pills or hormone replacement therapy) and testosterone
A group of blood pressure lowering drugs called calcium channel blockers (such as nifedipine, amlodipine, diltiazem, felodipine, and verapamil)
Steroids
Antidepressants, including MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (such as nortriptyline, desipramine, and amitriptyline)
 

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Discussion Starter #5
The pain when sitting sounds like sciatica, but I could be wrong. The swelling, probably need more info. In other words, does your grandfather have varicose veins, lymph issues, et al?

By chance, the pain medication the doctor gave your grandfather didn't happen to be Lyrica, did it? I had a neuro give that to me for pain arising out of a herniated disc in my neck and within a day I had cankles from hell and I had problems breathing. I didn't put two-and-two together immediately since I've had asthma and thought I just might be having an isolated incident; but after about a month of having problems breathing, I realized that the meds might be the cause. Sure enough, I researched it and not only is shortness of breath a side effect, but so was peripheral edema. I immediately tapered the drug off over the course of the next week.
No, he didn't take the pain medicine yet. I told him to hold off until I could do a little research for him. I'll look into sciatica. He's got a few varicose veins around his ankles, but none on his legs.
 

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No, he didn't take the pain medicine yet. I told him to hold off until I could do a little research for him. I'll look into sciatica. He's got a few varicose veins around his ankles, but none on his legs.
Well, varicose veins are a sign of impaired circulation. Generally, the deficiency is accounted for by the deep veins in the leg. However, with your grandfather's age and depending on how long he's had the veins in his ankles, perhaps some of the valves in those veins are beginning to fail. Gravity then wins. I'm not sure as to whether the fact that he only has issues with varicosities in his ankles might be the sole issue and whether the deep veins would end up playing a role in that instance.

I have a couple of friends who are podiatrists. I'll see if I can get more info on the latter from them.
 

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Discussion Starter #7
Well, varicose veins are a sign of impaired circulation. Generally, the deficiency is accounted for by the deep veins in the leg. However, with your grandfather's age and depending on how long he's had the veins in his ankles, perhaps some of the valves in those veins are beginning to fail. Gravity then wins. I'm not sure as to whether the fact that he only has issues with varicosities in his ankles might be the sole issue and whether the deep veins would end up playing a role in that instance.

I have a couple of friends who are podiatrists. I'll see if I can get more info on the latter from them.
Wow, thanks man. I really appreciate that. He doesn't have any numbness or tingling. Just a throbbing pain in his calfs if he sits w/ his knees bent. I'd never heard of anything like that before.
 

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My friend said that if your grandfather doesn't have high blood pressure that he may want to look into having a vascular study done. Also, he asked that if you push on the swelling, does it leave a depression or not? If it does, the swelling is related to vascular issues. If not, it's a lymphatic issue. He said that compression stockings may also help the issue - I did that when I had a bout of phlebitis when I struck a varicose vein while manning my dad's yacht.

One other question: does your grandfather have shooting pain? If not, it's probably related to the swelling. If so, it is likely neurologic in etiology.
 

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new doctor.
pain meds only mask the symptom, not cure the problem.


^
^
^
this advice is worth what your paying for it.

Not entirely true. Most pain meds are anti-inflammatories so they reduce the pain by reducing the inflammation that causes it
 

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All the above suggestions are good...

imho, I have found that leg pain that starts immediately with a change of position is more likely related to neurologic causes, such as lumbar spine, hip and knee joint pathology etc.

However, upon taking a real history, people often end up saying they have been sitting for an extended period of time. Standing straight, in older patients, often happens earlier in the day, and when walking...and both of these conditions are associated with decreased swelling...venous insufficiency (poorly functioning venous valves) is extremely common in older age groups.

Anyway, one could go on, but anything from that long list from above is possible based on the two lines of symptoms you've listed...I agree that a good physical exam and a duplex ultrasound will help...but you'll find neither on Lotustalk...:)
 
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